[Clinical features of major depressive disorders treated in secondary health care facilities in Chile]. / Características clínicas del trastorno depresivo mayor en tratamiento en el nivel secundario de atención.

BACKGROUND: Depression is considered the second leading cause of disability worldwide. AIM: To describe the clinical characteristics and the evolution of major depressive disorder (MDD) in secondary care. To evaluate the association between socio-demographic and clinic variables with the first or recurrent major depressive events (MDE). MATERIAL AND METHODS: Clinical features, treatment, remission and duration of MDE were evaluated during a follow up lasting 12 months in 112 participants aged 44 ± 15 years (79% women). Patients were assessed as outpatients every three months at three psychiatric care centers of Chile. Clinical interviews were carried out using DSM-IV diagnostic criteria checklists and the Hamilton Depression Scale was applied. RESULTS: Most patients were referred from primary care. The mean time lapse for referral to the secondary level was 10.8 months. Most patients had episodes that were recurrent, severe, with a high rate of psychosis, with suicide attempts and melancholic features and with psychiatric and medical comorbidities. Remission rate was 27.5%. In only 16 % of patients, the episode lasted six months or less. The group with recurrent episodes had different age, sex and clinical features. CONCLUSIONS: MDD treated at the secondary care level is severe and its symptoms are intense. The time lapse prior to referral was prolonged. Primary care management and referral of these patients should be studied more closely.

[Predictors of remission from major depressive disorder in secondary care]. / Predictores de remisión del trastorno depresivo mayor en tratamiento en el nivel secundario de atención.

Background The knowledge of predictive factors in depression should help to deal with the disease. Aim To assess potential predictors of remission of major depressive disorders (MDD) in secondary care and to propose a predictive model. Material and Methods A 12 month follow-up study was conducted in a sample of 112 outpatients at three psychiatric care centers of Chile, with baseline and quarterly assessments. Demographic, psychosocial, clinical and treatment factors as potential predictors, were assessed. A clinical interview with the checklist of DSM-IV diagnostic criteria, the Hamilton Depression Scale and the List of Threatening Experiences and Multidimensional Scale of Perceived Social Support were applied. Results The number of stressful events, perceived social support, baseline depression scores, melancholic features, time prior to beginning treatment at the secondary level and psychotherapeutic sessions were included in the model as predictors of remission. Sex, age, number of previous depressive episodes, psychiatric comorbidity and medical comorbidity were not significantly related with remission. Conclusions This model allows to predict depression score at six months with 70% of accuracy and the score at 12 months with 72% of accuracy.

Predicting Dendroctonus pseudotsugae (Coleoptera: Curculionidae) antiaggregation pheromone concentrations using an instantaneous puff dispersion model.

An instantaneous puff dispersion model was used to assess concentration fields of the Douglas-fir beetle, Dendroctonus pseudotsugae Hopkins, antiaggregation pheromone, 3-methylcyclohex-2-en-1-one (MCH), within a 1-ha circular plot. Several combinations of MCH release rate and releaser spacing were modeled to theoretically analyze optimal deployment strategies. The combinations of MCH release rate and releaser spacing used in the modeling exercise were based on results of previous field studies of treatment efficacy. Analyses of model results suggest that a release rate up to six times the initial standard, at a correspondingly wider spacing to keep the total amount of pheromone dispersed per unit area constant, may be effective at preventing Douglas-fir beetle infestation. The model outputs also provide a visual representation of pheromone dispersion patterns that can occur after deployment of release devices in the field. These results will help researchers and practitioners design more effective deployment strategies.

Características clínicas del trastorno depresivo mayor en tratamiento en el nivel secundario de atención / Clinical features of major depressive disorders treated in secondary health care facilities in Chile

Background: Depression is considered the second leading cause of disability worldwide. Aim: To describe the clinical characteristics and the evolution of major depressive disorder (MDD) in secondary care. To evaluate the association between socio-demographic and clinic variables with the first or recurrent major depressive events (MDE). Material and Methods: Clinical features, treatment, remission and duration of MDE were evaluated during a follow up lasting 12 months in 112 participants aged 44 ± 15 years (79% women). Patients were assessed as outpatients every three months at three psychiatric care centers of Chile. Clinical interviews were carried out using DSM-IV diagnostic criteria checklists and the Hamilton Depression Scale was applied. Results: Most patients were referred from primary care. The mean time lapse for referral to the secondary level was 10.8 months. Most patients had episodes that were recurrent, severe, with a high rate of psychosis, with suicide attempts and melancholic features and with psychiatric and medical comorbidities. Remission rate was 27.5%. In only 16 % of patients, the episode lasted six months or less. The group with recurrent episodes had different age, sex and clinical features. Conclusions: MDD treated at the secondary care level is severe and its symptoms are intense. The time lapse prior to referral was prolonged. Primary care management and referral of these patients should be studied more closely.

Predictores de remisión del trastorno depresivo mayor en tratamiento en el nivel secundario de atención / Predictors of remission from major depressive disorder in secondary care

Background The knowledge of predictive factors in depression should help to deal with the disease. Aim To assess potential predictors of remission of major depressive disorders (MDD) in secondary care and to propose a predictive model. Material and Methods A 12 month follow-up study was conducted in a sample of 112 outpatients at three psychiatric care centers of Chile, with baseline and quarterly assessments. Demographic, psychosocial, clinical and treatment factors as potential predictors, were assessed. A clinical interview with the checklist of DSM-IV diagnostic criteria, the Hamilton Depression Scale and the List of Threatening Experiences and Multidimensional Scale of Perceived Social Support were applied. Results The number of stressful events, perceived social support, baseline depression scores, melancholic features, time prior to beginning treatment at the secondary level and psychotherapeutic sessions were included in the model as predictors of remission. Sex, age, number of previous depressive episodes, psychiatric comorbidity and medical comorbidity were not significantly related with remission. Conclusions This model allows to predict depression score at six months with 70% of accuracy and the score at 12 months with 72% of accuracy.

Infección piógena diseminada por estafilococo aureus: reporte de un caso / Spread pyogenic infection by staphiloccocus aureus: a case report

El desarrollo de una infección estafilocócica guarda relación con la resistencia del huésped a las infecciones, y con la virulencia del microorganismo. La piel y las mucosas íntegras actúan como barreras para la invasión de los estafilococos. El riesgo de infección aumenta cuando esas barreras mucocutáneas son defectuosas debido a intervenciones quirúrgicas, traumatismos, cuerpos extraños y quemaduras. En nuestro trabajo presentamos un caso de infección piógena por estafilococo aureus que fue asistido en la Unidad de Cuidados Intensivos Pediátricos del Hospital General Provincial Docente de Morón. Se destacan las manifestaciones clínicas y se revisa la literatura médica(AU)

Cateterismo de la vena yugular interna en lactantes / Internal yugular vein catheterism in infants

Se realizó un estudio observacional descriptivo de tipo prospectivo de 23 lactantes ingresados en el Servicio de Terapia Intensiva Pediátrica del Hospital General Provincial Docente de Morón que por alguna razón necesitaron el abordaje de la vena yugular interna para la administración de fluidos, medicamentos y monitoreo de la presión venosa central (PVC) en el período comprendido entre enero y diciembre del año 2002. El catéter vygon número 17 se colocó en el 92,4 porciento de los lactantes de 1-3 meses. Las patologías que necesitaron el mayor número de cateterismo fueron las diarreas complicadas (34,7 porciento) y las sepsis ( 26,1 porciento). Los pacientes no complicados aportaron el mayor porciento del estudio (60,8 porciento), y la no progresión del catéter y la infección del mismo resultaron ser las complicaciones más frecuentes (50,0 porciento). Los lactantes desnutridos se complicaron con un 85,7 porciento y los que permanecieron con un catéter por más de 5 días (66,7 porciento)(AU)